Doula Services/Virtual
What is a Doula?
Doulas are trained and experienced in childbirth and are usually mothers themselves. They have a good knowledge and awareness of female physiology, but a doula does not support the mother in a medical role – that is the job of the midwife or doctor. She works on keeping birth calm and empowering, and should the birth become complicated and require medical assistance, a doula will still remain by your side and help in any way she can. She will not make the decisions for those she supports, but she assists them through the decision-making process and provides balanced information so the couple can make their own choices.
Many women consider doulas to be a must for those giving birth in a hospital, due to the over-medicalization of birth – unnecessary inductions have skyrocketed and are partly to blame for the 1 in 3 American babies now born by cesarean section. In America, some hospitals have cesarean section rates as high as 50% and higher. This is a terribly high statistic, well above World Health Organisation recommendations, which makes us amongst the highest in the world. Given the long-term emotional and physical effects this can have on the mother, her partner, and baby, a doula to me is like an ‘insurance policy – which can help protect you from a disempowering, disappointing experience or unnecessary procedures and intervention. With a doula, you know that someone is always on YOUR team, holding the space for you and your family. She works for you and has your best interests at heart, unlike hospital staff who have to abide by policies, which are not always best for a birthing woman, but best to avoid legal issues and to keep things running as a business.
A doula works in birth centers, private and public hospitals, and at homebirth in conjunction with midwives – but never as the sole caregiver at birth. Birthing without a midwife or doctor present is known as free-birthing, however, I recommend birth with at least a qualified midwife or doctor.
What Does A Doula Do?
A doula may provide some or all of the following, dependent on her training and skills (she may be more than just a doula – some doulas are also qualified in other therapies):
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Birth education and preparation
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Birth planning (including creating a written birth plan/birth preferences document)
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De-briefing previous births
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Breastfeeding Education and or assistance
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Massage and other comfort measures
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Optimal fetal positioning
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Suggest positions and changes to help ease pain and facilitate a smoother, more effective labor
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Provide reassurance and encouragement
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Talking through emotional blockages which may come up in labor
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Keep your ‘environment’ going – aromatherapy, music, candles, etc
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Assisting you with the negotiation of your birth preferences
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Postpartum or follow-up care
And so much more...
I believe the biggest bonus of a doula is the fact that she is a professional birth worker – she is skilled in the art of birth support and has a keen eye and intuition on what a laboring mother needs. Things that a hospital midwife, unfortunately, does not have time for, and things in which her partner may not pick up on or situations he may not know how to deal with. A doula has a disposition that is caring and nurturing, yet able to remain calm and focused even if things go off the rails. Family and friends tend to have an emotional connection that can interfere in the event of a problem or at the peak intense moments. A doula can think clearly, see the pros and cons of any situation and relay them to the couple to make their own decision. When a birthing mother is stressed, she may not make the best decisions, and possibly become completely agreeable to what’s being put on the table, because she is uncertain or scared. A doula can help explain what’s happening with compassion and without judgment or medical jargon, so it's easier for her to understand.
There are a few types of doulas - antepartum, birth, and postnatal doulas. Many doulas perform both roles. The difference is that the role of the post-natal doula is to nurture the mother at home after childbirth. This may include further breastfeeding support, light home duties, massage, emotional and physical support for the mother, and so on. Postnatal doulas are particularly in demand, as support for new mothers has been reduced in modern society. Needless to say, studies show that postnatal doulas make a huge impact on the well-being of mothers.
My Promise As Your Doula :
1. You cannot hurt my feelings in labor
2. I won’t lie to you in labor
3. I will do everything in my power so you do not suffer
4. I will help you to feel safe
5. I cannot speak for you, but I will make sure that you have a voice and I will make sure you are heard
What Are The Proven Benefits Of A Doula?
A recent review of many studies from around the world has concluded that a doula’s support is more effective than hospital staff, friends, or family. Studies (and reviews of the studies) consistently demonstrate very impressive benefits for the mother, father, and baby, including:
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50% fewer cesarean sections
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Reduction in the use of forceps vacuum by 40%
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60% fewer requests for epidurals
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40% reduction in the use of synthetic oxytocin for inductions or augmentations
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30% reduction in the use of pain medication
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25% reduction in labor length
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Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
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Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum
These are not misprints! The benefits are significant. Most of the women in the studies were accompanied by male partners. However, study results show that women who had the support of a male partner and a doula fared best, for example, the cesarean rate of women supported by both a male partner and a doula was significantly lower (15.4%) than the cesarean rate for women supported only by their partners (24.4%) and drastically less for women without any support.
What About The Woman’s Partner – Does a Doula Replace Them?
No. According to the studies (and from personal observations in births I have attended) rather than reducing a partner’s participation in the birth process, a doula’s support complements and reinforces their role. Partners feel more enthusiastic and that their contribution to the labor and birth was meaningful and helpful. I often find when partners have a visual on how to support a woman i.e. watching a doula support her, they feel more confident and relaxed having seen some ideas to try themselves. In the studies, not only did partners report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with her partners' role at birth too. Over 30% of women reported that their relationships were better post-birth than they were prior to the birth.
How Much Does A Doula Cost?
This varies greatly dependant on experience, the state the doula is located in, and what packages are on offer. A package offering pre and post-natal visits (generally around 2 hours long each) as well as the duration of the birth can cost around $800-$1500 for an experienced doula in most states, but others charge up to $2,000. Doulas often only attend 1-3 births a month, as many are mothers with young children. Finding last-minute childcare as well as spare time to do visits and attend births is a tricky balance. The births often happen during family time on weekends or after hours. So it’s not something women do for monetary benefits, but passion. If you actually did the sums and worked out how much a doula charges, broken down to an hourly rate, it's not significant, and for me pales in comparison to the massive physical and emotional health benefits to not only mother but baby and partner.
Post-Natal Doulas
After the birth of your baby, post-natal doulas are worth their weight in gold. A birth doula may also be a post-natal doula, or some doulas choose to train as post-natal doulas only. They come into your home and help you out with a huge range of things that will make your days easier and more relaxed. What a post-natal doula offers is varied so you need to check with them what they offer, but here are a few things that may be included:
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Breastfeeding support
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Infant massage techniques
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Bonding support
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Birth debriefing/ counseling
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Cleaning
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Cooking
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Driving / running errands
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Settling/sleep help with the baby
Packages and prices vary depending on the need. Average prices start around $25 per hour. A minimum amount of hours will be required, usually 4. Make sure you communicate what you want from me as your doula to ensure there are no miscommunications and all expectations are realistic and met accordingly.